Author Archives: churchc

No ice epidemic but rising purity is doing damage, say researchers

The Guardian Melissa Davey 14 October 2014

There is no ice epidemic sweeping Australia, despite what politicians and police might say, a report led by one of the country’s leading drug researchers has found.

Paul Dietze, from the Burnet Institute in Melbourne, said there had been a dramatic increase in the purity of crystal methamphetamine, known as ice, which was increasing the level of damage caused by the drug.

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Clinical and forensic signs related to chemical burns: a mechanistic approach

Burns Available online 1 October 2014;    DOI: 10.1016/j.burns.2014.09.002

This manuscript highlights and critically analyses clinical and forensic signs related to chemical burns. Signs that may lead to suspicion of a particular chemical are thoroughly discussed regarding its underlying mechanisms. Burns due to sulfuric, hydrofluoric, nitric, hydrochloric (muriatic) and acetic (including derivatives) acids, hydrogen sulphide, sodium (caustic soda) and calcium (cement) hydroxides, paraquat, burns after inflation and rupture of airbags, povidone–iodine, chlorhexidine/alcohol (in preterm infants), laxatives, and vesicants (warfare agents), will be reviewed since these are the most common agents found in daily practice, for which relevant and timed information may be helpful in formulating an emergency treatment protocols and toxicological analysis.

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Driving under the influence among frequent ecstasy consumers in Australia: Trends over time and the role of risk perceptions

Drug and Alcohol Dependence Available online 1 October 2014;    DOI: 10.1016/j.drugalcdep.2014.09.015

Background

Driving under the influence (DUI) of alcohol and illicit drugs is a serious road safety concern. This research aimed to examine trends in DUI across time and changes in attitudes towards the risks (crash and legal) associated with DUI among regular ecstasy users (REU) interviewed in Australia.

Methods

Participants were regular (at least monthly) ecstasy users surveyed in 2007 (n = 573) or 2011 (n = 429) who had driven a car in the last six months. Face to face interviews comprised questions about recent engagement of DUI and roadside breath (alcohol) and saliva (drug) testing. Participants also reported the risk of crash and of being apprehended by police if DUI of alcohol, cannabis, ecstasy, and methamphetamine.

Results

There were significant reductions in DUI of psychostimulants (ecstasy, methamphetamine, cocaine, LSD) but not alcohol or cannabis between 2007 and 2011. This was accompanied by increased experience of roadside saliva testing and increases in crash and legal risk perceptions for ecstasy and methamphetamine, but not alcohol or cannabis. When the relationship between DUI and risk variables was examined, low crash risk perceptions were associated with DUI of all substances and low legal risk perceptions were associated with DUI of ecstasy.

Conclusions

The observed reduction in DUI of psychostimulants among frequent ecstasy consumers may be related to increased risk awareness stemming from educational campaigns and the introduction of saliva testing on Australian roads. Such countermeasures may be less effective in relation to deterring or changing attitudes towards DUI of cannabis and alcohol among this group.

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A comparison of the combined-use of alcohol & energy drinks to alcohol-only on high-risk drinking and driving behaviors

Subst. Use Misuse September 30, 2014;  doi:10.3109/10826084.2014.935948

Background: The combined-use of alcohol and energy drinks is an emerging public health issue. This investigation examined differences in drinking and driving behaviors among combined-users (CU) and participants who consumed alcohol-only (AO). Objectives: This study was specifically designed to investigate potential differences in drinker’s perceptions of (a) what it means to them to drive over the .08 Blood Alcohol Content (BAC) driving limit and (b) what it means to drive after knowing they have had too much to drink to drive safely. Methods: College students (N = 355) were surveyed to assess differences in drinking and driving-related behaviors between the AO (n = 174) and CU (n = 107) groups. Results: CU were more likely than AO to drive over the .08 BAC driving limit (53% vs. 38%; p = .009) and after knowing they were too drunk to drive (57% vs. 44%; p = .025). CU were also more likely (56% vs. 35%; p = .000) to ride with an intoxicated driver while knowing it was unsafe. Conclusions/Importance: Combined-users are more likely to drive after drinking, drive while knowingly drunk, and participate in other high-risk behaviors such as heavy drinking that increase the potential for injury. Public policy makers and health professionals should focus prevention efforts to reduce high-risk combined-use behavior.

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Does β-APP staining of the brain in infant bed-sharing deaths differentiate these cases from sudden infant death syndrome?

Journal of Forensic and Legal Medicine Volume 27, October 2014, Pages 46–49;  DOI: 10.1016/j.jflm.2014.07.006

Archival cerebral tissue from infants whose deaths were attributed to sudden infant death syndrome (SIDS) from South Australia and Western Denmark were stained for β-amyloid precursor protein (β-APP) and graded according to a simple scoring chart. The resulting APP scores were correlated with sleeping situation (shared vs. alone) showing a significantly higher amount of β-APP staining in the non-bed-sharing, than in the bed-sharing infants (Mann–Whitney, Australia: p = 0.0128, Denmark: p = 0.0014, Combined: p = 0.0031). There was also a marked but non-significant difference in sex distribution between bed-sharers and non-bed-sharers with a male to female ratio of 1:1 in the first group and 2:1 in the latter. Of 48 Australian and 76 Danish SIDS infants, β-APP staining was present in 116 (94%) cases. The eight negative cases were all from the Danish cohort. This study has shown that the amount of β-APP staining was significantly higher in infants who were sleeping alone compared to those who were bed-sharing with one or more adults, in both an Australian and Danish cohort of SIDS infants. Whether this results from differences in the speed with which these infants die, differences in lethal mechanisms involving possible accidental asphyxiation in shared sleepers, or differences in the number of previous hypoxic-ischemic events, remains to be clarified.

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Uncertainty of gamma-ray spectrometry measurement of environmental samples due to uncertainties in matrix composition, density and sample geometry

Applied Radiation and Isotopes Volume 94, December 2014, Pages 306–313;  DOI: 10.1016/j.apradiso.2014.08.008

This paper is intended to identify the uncertainties of activities in environmental samples measured with gamma-ray spectrometry that result from uncertainties in matrix composition, density and geometrical dimensions of the sample. For that purpose efficiencies were calculated for a wide range of environmental matrices such as fresh and ashed food samples, water samples and soil samples. Compositions were mainly taken from literature. Densities and geometry parameters were varied in a range occurring in practice. Considered energies cover a range from 46.5 keV to 2000 keV. Finally, a couple of recommendations in respect to gamma-ray spectrometric measurements of environmental samples are given.

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Trauma to the hyoid bone and laryngeal cartilages in hanging: Review of forensic research series since 1856

Legal Medicine  Available online 5 October 2014;  DOI: 10.1016/j.legalmed.2014.09.005

Since 1856 lots of forensic reports, concerning trauma to the hyoid bone and laryngeal cartilages in hanging, have been published. Differences in percentage of injured neck complexes ranged from 0 to 83.3%. Simple arguments suggest that the reason for discrepancy is difference in scientific approach (retro- or prospective) and use of various research methods. Comparative analysis of widely used techniques shows considerable variety in their effectiveness. Plain radiography and palpatory method have fairly low sensitivity (33–60% for different elements of the neck complex) with relatively high specificity (89–98.5%). Reported sensitivity of postmortem CT in identification of different lesions (including fractures) in trauma victims for the head/neck region is higher than 53% in different series with possible false-positive findings. In clinical setting the whole-body CT (pan-scanning) in blunt trauma patients showed sensitivity for head and neck injuries at the level of 84.6%, and specificity – 98.9% (Stengel et al., 2012 [68]). Only complete preparation allows to identify all the damages to the laryngopharynx framework, to avoid false diagnostics and ascertain the exact location, morphology, mechanism and intravital nature of the neck trauma. Currently complete preparation can be regarded as the method of “gold standard”. Use of this method shows the frequency of discovered injuries in hanging to be about 70% of cases. In practical use, one should consider radiological techniques and palpation as preliminary and orienting methods (rather excluding, than revealing anterior neck trauma).

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